Melatonin

[zzisaac]

How do others handle melatonin at overnight camps? We distribute it with other HS meds, but last summer had so many parents call to request their child take it right before their head hit the pillow as opposed to HS time. It's too difficult to have the counselors do it - they are so busy with other things and have time off at night - so it's a bit inconsistent. Thoughts on how to handle this?

[Alex Egan, LPN, EMT-B]

We have some Meds that are dispensed by the head counselors and group leaders from the local headquarters. These are things like ADHD meds that they want given right in the morning, Prilosec they want given 30min before eating, allergy meds and melatonin that the parents want to be right before sleep. Camp goes to bed and gets up at different times so it's tuff to time led dispensing around these parameters. We set up a MAR and encourage camp meds. A nurse is assigned to the headquarters to monitor that these meds are going out. The kids who need it don't miss the melatonin. The kids who are on the ADHD meds...well the cabin staff won't miss those more then once. The allergy meds are a little harder, we REALLY stress to the parents that if they want the off times then administration can be a little less reliable. I know it's not perfect, and maybe not kosher as far as non nurses dispensing meds, although it is with supervision and routine meds, but it was the camp culture and really does seem to work.

[kaufer01]

All of our HS meds are dispensed from the health center. "Minutes" are called 10 minutes prior to lights out for our younger campers. These last 10 minutes before bed are when kids are supposed to come and get meds, brush teeth, etc. The older kids come and get their meds a little bit later because they have a later bedtime. We haven't really had an issue with parents wanting their child to get it right before their head hits the pillow. When screening forms and following up with parents we let them know when our med administration times are and the process we use for giving meds and most parents don't have an issue with it.

[tining, BSN, RN]

My director knows how hard we work and when this type of issue rolls across the desk he backs us up. We do not allow lower camp (under 10yo) to take with them, and will give an exception to a responsible last year camper since they stay up really late.

Along these lines we have had parents requested that their little cupcake have their medication in pudding, applesauce, Hershey's syrup, and (OMG) cookie dough. Parents are so inventive - new thread! Our answer is a spoonful of pudding only, even though that is annoying as well.

[zzisaac]

Thank for your response- yes we try and work within the camp culture as that is so important, we have also utilized the lead counselors in the morning for the early morning meds, they just seem to be less reliable for the night times ones. I'll keep thinking about this!

[zzisaac]

tining- that is so true that we could have an entire new thread about special requests! Yes, and not just in ice cream, but in vanilla, not chocolate, and at room temperature..oy.

I like that you have in your policy a spoonful of pudding. While I do think the camp I work at is excellent and teaches kids all the things they need learn, they do bend over backwards to accomodate special requests. Which doesn't really fit with a philosophy of teaching resilience. There has to be some reasonable limits. We have allowed the oldest camper to pick up the melatonin at the hs med pass, and then take it later at their cabin, but some of the nurses are not comfortable with that at all.

[CloudySue]

Usually the kids who really believe they need melatonin to help them sleep do come to the HC nightly without fail. We had some other kids who had them HS but never showed up to take them... and they slept like rocks anyhow.

There was one teen girl who talked another nurse into letting her take her melatonin with her back to the cabin, promising to take it right before she went to sleep. She fell asleep before she got to take it, but awoke around 6am and, seeing that it was too early to get up, she popped that melatonin and went right back to sleep. Less than 2 hours later, the campers were awakened to start their day but this girl just couldn't wake up! She eventually dragged her butt out of bed but she was a zombie for most of the day until the melatonin worked its way out of her system. After that I made it my business to educate every melatonin-taker on how it worked!